Harm Minimisation Drug Policy Implementation Efficacy Among Australian Community Based People Who Inject Drugs

Abstract

Background: Harm minimisation drug policies prioritise the reduction of harm to people who use drugs and the wider community through harm reduction (HR) approaches. A critical harm reduction intervention for People Who Inject Drugs (PWID) are Needle and Syringe Programs (NSPs). Beholden to political and epidemiological agendas, NSP success is dependent on accessibility and utilisation among PWID. Implementation of NSPs, can be described as a patchwork of diverse practices and regulations across international, national, and local levels. Aims: We aimed to map emerging evidence, engage in organic partnership building and examine implementation qualities as prioritised by NSP providers and PWID. Methods: Mixed methods were utilised across three studies. Firstly, a scoping review of six articles addressing sustainable NSP implementation. Secondly, organic collaborative research partnership building with NSP providers (n=26) and PWID (n=70) who contend with real-world constraints of service delivery and utilisation. Thirdly, implementation science methodology to broaden understanding and effectiveness of policy adoption as applied to NSP implementation. Results: Trending literature indicated sustainable NSPs require provider, consumer, and community engagement, supported by enabling health policies. Organic collaborative research partnership approaches resulted in strong partnerships and increased capacity building. Non-parametric data analysis indicated NSP service providers prioritised compatibility while PWID prioritised resourcing. Conclusions: Findings suggest HR approaches guided by implementation science demonstrate efficacy associated with accessibility and serviceability for NSP providers and PWID. Findings are consistent with trending recognition of substance use as a health issue, not a criminal justice one, while showcasing how collaborations and implementation science can promote NSPs that are consumer responsive.